Background: Renal involvement is common in systemic lupus erythematosus (SLE) and can lead to chronic kidney disease (CKD). Diagnosis of lupus nephritis (LN) is dependent on renal biopsy. Due to its invasiveness, repeat renal biopsy for monitoring disease activity is not recommended, thus creating a need for noninvasive and accurate biomarkers. Monocyte chemoattractant protein-1 (MCP-1) and tumour necrosis factor-like weak inducer of apoptosis (TWEAK) have been implicated in the pathogenesis of LN and are thus potential biomarkers for disease activity monitoring. Methods: In this study urinary MCP-1 (uMCP-1) and TWEAK (uTWEAK), together with standard markers of disease activity, were analysed in a cohort of 50 biopsy-proven LN patients at baseline, after sixmonths of induction therapy, and at one-year. Results: Throughout the study there was correlation between uMCP-1 and uTWEAK (r=0.52, p< 0.001). Both biomarkers also correlated with standard of care tests and clinical scores. The median [interquartile range] of uMCP-1 and uTWEAK were significantly increased in the active group when compared to the quiescent group (1440 [683–2729] vs 256 [175–477] pg/mL, p< 0.0001, and 209 [117–312] vs 74 [11– 173] pg/mL, p=0.0008, respectively). After completion of induction therapy in the active group, there was no significant difference in biomarker results between the groups. The sensitivity and specificity for indicating disease activity was 95% and 73% for uMCP-1 (area under curve [AUC]=0.875), and 60% and 90% for uTWEAK (AUC=0.783), respectively. Conclusion: uMCP-1 and uTWEAK reflect LN disease activity, and correlate with standard of care biomarkers in a South African cohort. Further studies are needed to assess additional clinical benefit.

The notion that insulin binds to a specific site on the cell membrane was first proposed many years ago. However, experimental proof of a membrane bound insulin receptor did not come until the early 1970s when biologically active radiolabelled insulin was used in direct binding studies (Cuatrecasas, 1971). Recent advances in understanding the mechanism of insulin action are the result of studies on the structure and function of the insulin receptor. The membrane receptor would appear to have two functions: firstly, it must bind insulin and secondly, it must couple insulin binding to insulin action. Defects in either of these receptor functions will result in an impaired response to insulin, or insulin resistance (Taylor, 1985). Insulin resistance is a common disorder in a number of disease states in man. For example, non-insulin-dependent diabetes mellitus and obesity are associated with mild insulin resistance (Bar et aZ., 1976). There are also a number of relatively rare syndromes of extreme insulin resistance in which there is either impaired receptor function, or an immunological defect resulting in the development of auto-antibodies against the insulin receptor (Taylor et aZ., 1985).Studies on insulin receptor defects associated with these disease states have led to progress in understanding the molecular mechanisms of insulin action. Ideally when investigating these disease states one should study insulin action on classical target cells such as adipocytes, hepatocytes or muscle. However, it is now well established that the kinetics of insulin binding to its membrane receptor is similar in all human tissue whether or not it is a target for insulin action. This has led to a great deal of research on the more accessible human tissues such as monocytes, erythrocytes, cultured fibroblasts and Epstein-Barr virus (EBV) transformed B-Iymphocytes. The most convenient tissue to study is EBV transformed B-Iymphocytes, as these cells can be taken from individual patients and grown in culture in large quantities, which facilitates biochemical studies. Despite these advantages, it is important to establish that this virus-induced receptor is a true insulin receptor and not an artifact of viral transformation. Studies on B-Iymphocyte proliferation have shown that the insulin receptor appears on the cell membrane during the proliferative phase of B-cell activation. However , this is a transient event and once the cell reaches maturation the insulin receptor is no longer evident (Marchalonis & Galbraith, 1987). The insulin receptor has also been demonstrated in a number of cultured human lymphoblastoid cell lines (Gavin et aL, 1983; Maegawa et aL, 1983). It seems, therefore, that the insulin receptor is normally expressed by blast cells. The purpose of this study was to investigate insulin binding characteristics on a human lymphoblastoid cell line with B-cell characteristics which was originally derived from a patient with Burkitt's lymphoma. These cells, which are known as Raji cells, are unusual in that they carry multiple copies of the EBV genome in their DNA. For this reason they provide a useful model system for studying the insulin receptor in EBV transformed lymphocytes. In addition, studies on the mechanism of insulin action in these cells should give some insight into the function of the insulin receptor during B-cell proliferation. In this study four major characteristics of insulin binding to insulin receptors on Raji cells are described. Firstly, on the basis of kinetic studies a model for insulin-receptor interaction was established. Secondly, processing of insulin and the receptor was investigated to determine whether the receptor is functional. A third aspect was elucidation of the receptor structure and the insulin binding site. Finally, the cross-reaction between insulin and type I IGF receptors was studied, and the cellular response mediated by the insulin receptor and growth factor receptor was determined. / Thesis (M.Med.Sc.)-University of Natal, Durban, 1988.

Venoms from the most poisonous snakes found in Saudi Arabia were assessed for their physical and chemical characteristics and for their enzymatic and biological activities. Venom from Atractaspis microlepidota was the most lethal in mice followed by the elapids Naja haje arabica and Walterinnesia aegyptia. Among the vipers, Cerastes cerastes venom was the most lethal whereas the remainder (Echis pyramidum, Echis coloratus and Bitfis arietans) showed similar but lower lethality. Antivenoms were raised in sheep by immunising with a low dose of venom (0.5mg) which was then doubled every four weeks. To optimise the antibody response, groups of sheep were immunised with a low, medium and high dose and the monthly bleeds were assessed by ELISA and small-scale affinity chromatography. The immunoglobulin fraction was partially purified by sodium sulphate precipitation and digested with either papain, to form Fab fragments, or with pepsin to produce F(ab)2. The different antivenom fractions produced were characterised and assessed for their ability to neutralise the enzymatic and biological activities of the corresponding venoms. Fab was equally effective as F(ab)2 in most enzymatic and biological assays but the two fractions were less efficient than IgG. The ovine Fab provided good protection in mice against the lethality of these venoms and effectively neutralised their biological and enzymatic activities. The commercial antivenoms currently available in Saudi Arabia showed only partial neutralisation of the enzymatic and biological activities of these venoms and showed in vivo protection only when using large amounts. They offered no protection against W. aegyptia venom. The monospecific ovine Fab raised against E. pyramidum and E. coloratus venoms were more efficient than the polyspecific Fab raised against a mixture of the two venoms.

No abstract available.

The decapeptide, gonadotropin releasing hormone (GnRH), is the central regulator of reproductive function. It binds to receptors on the gonadotrope cells of the pituitary and stimulates release of luteinizing hormone (LH) and follicle stimulating hormone (FSH). Eleven different structural forms of GnRH have now been identified in various animal species. Chimaeric analogues of some of the variant forms of GnRH were synthesized in order to study the functional significance of the most common amino acid substitutions, which occur in positions 5, 7 and 8. Peptide binding affinities for sheep and rat GnRH receptors and potencies in stimulating LH and FSH release from cultured sheep pituitary cells and LH release from cultured chicken pituitary cells were measured. Histidine in position 5 decreased LH releasing potency in chicken cells, but slightly increased receptor binding affinity in rat and sheep membranes. Tryptophan in position 7 had minimal effect on GnRH activity in mammals, but increased LH release in chicken cells. Although differences in the structural requirements of mammalian and chicken GnRH receptors were anticipated, it was also found that rat GnRH receptors exhibited higher affinity for analogues with Tryptophan in position 7, than did sheep GnRH receptors. Substitutions in position 8 revealed the most marked differences in the structural requirements of mammalian and chicken GnRH receptors. Arginine was required for high GnRH activity in mammalian systems, but analogues with neutral substitutions in position 8 were more potent in chicken pituitary cells. The tolerance of position 8 substitutions, combined with the relatively small effects, in chicken cells, of incorporating a D-amino acid in position 6, indicate that the chicken GnRH receptor is less stringent than mammalian receptors in its recognition of peptide conformation. To examine how changes in ligand structure cause changes in receptor binding affinity and receptor activation, it was necessary to know the structures of the GnRH receptors. A protocol was developed for the purification of GnRH binding proteins from detergent-solubilized pituitary membranes, by affinity chromatography. This procedure yielded a protein which migrated as a single band on sodium dodecyl sulfate polyacrylamide gel electrophoresis, but was different from the recently cloned GnRH receptor. To test the proposal that the arginine residue in mammalian GnRH interacts with an acidic receptor residue, eight conserved acidic residues of the cloned mouse GnRH receptor were mutated to asparagine or glutamine. Mutant receptors were transiently expressed in COS-1 cells and tested for decreased preference for Arg⁸-containing ligands by ligand binding and inositol phosphate production. One mutant receptor, in which the glutamate residue in position 301 was mutated, exhibited decreased affinity for mammalian GnRH. The mutant receptor also exhibited decreased affinity for [Lys⁸]-GnRH, but unchanged affinity for [Gln⁸]-GnRH compared with the wildtype receptor, and increased affinity for the acidic analogue, [Glu⁸]-GnRH. This loss of affinity was specific for the residue in position 8, because the mutant receptor retained hiszh affinity for analogues with favourable substitutions in positions 5, 6 and 7. Thus, the Glu³⁰¹ residue of the GnRH receptor plays a role in receptor recognition of Arg⁸ in the ligand, consistent with an electrostatic interaction between these two residues. The Glu³⁰¹ and Arg⁸ residues were not required for the high affinity interactions of conformationally constrained peptides. This indicates that an interaction which involves these two residues may induce changes in the conformation of GnRH after it has bound to the receptor.

This research was undertaken in order to design techniques and processes that enable the manufacture of effective antivenoms. To prepare a broad specificity anti venom for European vipers from chicken yolk it was first necessary to develop a simple effective method to extract avian immunoglobulin (lgY). A specific fluoroimmunoassay was developed to monitor IgY recovery and serum IgY levels in immunised hens. The most promising extraction methods from the literature were compared using a triglyceride kit to monitor lipoprotein removed and SDS-PAGE and ELISA to monitor purity and activity respectively. Caprylic acid followed by ammonium sulphate proved the best method. Unfortunately only low levels of specific IgY were achieved and it was necessary to include an affinity purification step to demonstrate their effectiveness in an EDso test. Pepsin, papain and trypsin all produced Fab' fragments from IgY but only pepsin digested the resultant Fc fragments. Pepsin could also digest other proteins in egg yolk, thereby avoiding the need to salt fractionate IgY prior to its digestion with a consequent improvement in the recovery of Fab'. A small scale affinity purification (SSAP) assay was developed, characterised and used to determine specific antibody levels in ovine antisera. Small doses (l5IAg) of venom produced significant specific levels but larger doses produced a better response and were used to produce anti venom. Binding studies with SSAP demonstrated a high concentration of specific antibodies in V.latastei antisera that bind to components in the venoms of other European vipers. A specific ovine F(ab')2-based V.latastei antivenom approximately twice as potent as the anti venom used currently in Spain was prepared from the ovine antisera. Evidence is presented that SSAP should supersede manual ELISA for assessing specific antibody levels in antisera. No major gain in recovery and purity resulted from processing whole blood rather than serum for preparing antivenom.

No abstract available. / Thesis (Ph.D)-University of Natal, 1986.

In this thesis a detailed study of the kinetics of GnRH-stimulated LH release was made. GnRH stimulated LH release in a biphasic manner. During the first 3 minutes of stimulation, there was a transient spike phase of release followed by plateau phase of lower amplitude. Both phases of release are largely dependent on extracellular Ca²⁺. The spike phase of release is dependent on Ca²⁺ entry via a receptor-operated Ca²⁺ channel (ROCC) (about 90%) and on the mobilization of intracellular Ca²⁺ stores. The role of ROCC were examined by using ruthenium red which inhibits both ROCC and voltage-sensitive Ca²⁺ channels (VSCC). VSCC are not involved in the spike phase of GnRH-stimulated LH release since D600 and nifedipine, inhibitors of VSCC, have no effect on the spike phase. The plateau phase of release is dependent on Ca²⁺ entry via VSCC (about 50%) and ROCC (about 50%). Forskolin, an activator of adenylate cyclase, was used to investigate the role of cAMP in LH release. Forskolin stimulated an increase in both LH release and cellular cAMP levels. GnRH was also able to elevate the cellular CAMP concentration. GnRH interacted synergistically with forskolin to stimulate LH release. The synergism between GnRH and forskolin was not due to an interaction at (1) the GnRH receptor, (2) the level of intracellular Ca²⁺ mobilization, or (3) inositol phosphate metabolism. However, forskolin was able to synergistically interact with secretagogues that increase the cytosolic Ca²⁺ concentration and activators of protein kinase C. This suggested that forskolin was interacting with GnRH at a site distal to the activation of the Ca²⁺ second messenger system and protein kinase C. The data suggest that the initial response to GnRH is largely Ca²⁺-dependent and that other second messengers, if active, play a minor role. cAMP is thought to play a modulatory role and may be involved in the maintenance of secretion.

In the first part of this study, the kinetics of decay of TNP-nucleotide superfluorescence was investigated with a view to understanding the role of nucleotides and Lys492 in later steps in the catalytic cycle of the skeletal muscle Ca²⁺ATPase. It has been found previously, and verified here, that tethering TNP-8N₃-AMP to the Ca²⁺ATPase via Lys492 retarded the Ca²⁺ initiated decay of Pᵢ-induced superfluorescence 10-fold compared with untethered nucleotide. The rapidity of the decay upon addition of EDTA suggested that the E₂ ↔ E₁ → E₁Ca₂ steps were being monitored rather than dephosphorylation per se. Tethered diand triphospho species did not accelerate the decay. While monophasic kinetics was observed with untethered TNP-AMP and TNP-8N₃-AMP, complex kinetics were observed with the di- and triphospho TNP-nucleotides. This was shown to be due to the utilization of TNP-ADP and -ATP, and the azido derivatives, as coupled substrates of the Ca²⁺ATPase in the forward direction of catalysis in the presence of Ca²⁺. The hydrolysis rates of TNP-ADP, TNP-ATP, TNP-8N₃ -ADP, and TNP-8N₃ -ATP were 10, 5, 15 and 10 nomoles/min/mg of protein, respectively, at room temperature and pH 5.5. Ca²⁺ transport was supported by all four nucleotides. This is the first time that a diphosphonucleotide has been shown to support Ca²⁺ transport. A new nonhydrolysable triphospho TNPnucleotide, TNP-AMP-PCP was synthesized and shown to interact with the Ca²⁺ATPase in a similar way, in terms of superfluorescence, as the other TNP-nucleotides. It did not show the complex kinetics on inhibition of the Pcinduced superfluorescence by Ca²⁺, but neither did it accelerate the kinetics. It was concluded that TNP-nucleotides do not accelerate the E₂ ↔ E₁ transition under these conditions, possibly because of the presence of glycerol in the medium. In the second part of the study, it was shown that addition of small amounts of chelators EGTA, EDTA, BAPTA, DTPA, HEDTA and NTA to a Ca²⁺ transport assay in which the free Ca²⁺ concentration is monitored by Fluo-3 causes the Ca²⁺ATPase to pump to apparently lower levels as seen in the [Ca²⁺] lim fluorescence. Addition of chelator retards pump function in the sense that it takes longer for 50 nmols Ca²⁺ to be accumulated. Increased thermodynamic efficiency of the pump and contaminating heavy metal ions were considered as possible mechanisms. To some extend Zn²⁺ and Cd²⁺, but not Fe²⁺ and Cu²⁺, appeared to reverse the partial inhibition. While interpretation of the results is difficult, it is suggested that heavy metal ions interact with luminal loops of the Ca²⁺ATPase and enhance Ca²⁺ release under conditions of high luminal Ca²⁺ concentrations.

A citrullinemic fibroblast cell line was used in this study to investigate two biochemical pathways involving citrulline. In the first section, the genetic mutation responsible for the argininosuccinate synthetase (-ASS) deficiency (1-5% activity) in this cell line was investigated. PCR analysis of the ASS cDNA revealed that the mRNA coding region (1236bp) was intact, showing no signs of major rearrangements. The ASS cDNA (1307bp) was cloned and sequenced and showed the presence of a single base mutation at position 1045bp, which represented a G->A transition. This mutation resulted in a glycine -> serine amino acid substitution at position 324 in the ASS subunit protein sequence. Although this glycine residue was not found to occur in any potential substrate binding sites, it was shown to be highly conserved among species, indicating a possible role of this amino acid in ASS catalytic activity. In the second section, the presence of the nitric oxide pathway in fibroblasts was investigated. Inducible nitric oxide synthase activity was assayed by measuring the production of ¹⁴C-citrulline from ¹⁴C-arginine after cytokine stimulation. By using the citrullinemic cell line (ASS deficient) any citrulline that may be produced by this pathway would accumulate, allowing detection. Under the assay conditions that were tested, no detectable ¹⁴C-citrulline was formed. Evidence suggests that human fibroblasts have the potential to synthesise nitric oxide, although a more sensitive assay system may need to be employed (longer cytokine activation, nitrite/nitrate detection).